Medicare Part D

Extra Help in 2026: Lower Your Medicare Drug Costs

TAUNTON, Mass. — If prescription costs are stretching your monthly budget, there's a federal program that could ease the pressure. It's called Extra Help, also known as the Low-Income Subsidy (LIS), and it helps people with Medicare pay for their Part D prescription drug coverage.

Extra Help has been around for years, but recent updates have made it available to more people than before. If you live in Taunton and rely on prescription medications, it's worth knowing what the program covers and how to check if you qualify.

What Extra Help actually does

Extra Help is a federal program that pays part — or in some cases nearly all — of your Medicare Part D prescription drug costs. That can include your monthly Part D plan premium, your annual deductible, and the copays you pay at the pharmacy counter.

According to CMS — Medicare Part D program rules (medicare.gov), people who qualify for full Extra Help pay no more than a small, set amount for each covered generic or brand-name drug. The exact copay amounts are updated each year by Medicare.

Extra Help works alongside your Part D plan or a Medicare Advantage plan that includes drug coverage. You still choose your own plan, but the subsidy lowers what you owe.

Who qualifies in 2027

To qualify for Extra Help, you need to be enrolled in Medicare and meet income and resource limits set by the Social Security Administration.

Starting in 2024, the Inflation Reduction Act expanded the program so that anyone earning up to 150% of the federal poverty level can now receive the full Extra Help benefit. Before that change, people between 135% and 150% only received a partial subsidy. That expansion carries into 2027.

Resource limits apply too. These include money in checking and savings accounts, stocks, and bonds — but not your home, one car, or personal belongings. Social Security publishes the current limits each year, so it's worth checking ssa.gov before you apply.

Some people are automatically enrolled in Extra Help. That includes people who have both Medicare and Medicaid, people in a Medicare Savings Program, and people who get Supplemental Security Income (SSI).

How Extra Help fits with the Part D changes for 2027

Medicare's prescription drug benefit looks different now than it did just a couple of years ago. A few key changes to keep in mind:

• The out-of-pocket cap for Part D is $2,100 in 2026 and $2,400 in 2027. Once you spend that much on covered drugs in a year, you pay nothing more for the rest of the year.
• The maximum Part D deductible is $615 in 2026 and $700 in 2027, though many plans set a lower one.
• The coverage gap (or "donut hole") is gone as of 2025. Part D now has three phases instead of four.
• The Medicare Prescription Payment Plan lets you spread your yearly drug costs into monthly payments — an option that can help with budgeting.

Extra Help stacks on top of these protections. If you qualify, your costs are lowered before you ever hit the annual cap, and your plan premium may be reduced or eliminated.

How to apply

You can apply for Extra Help at any time — you don't have to wait for the Annual Enrollment Period (October 15 – December 7) or the Medicare Advantage Open Enrollment Period (January 1 – March 31).

There are three easy ways to apply:

• Online at ssa.gov/extrahelp
• By phone at 1-800-772-1213 (TTY 1-800-325-0778)
• In person at your local Social Security office

Applying is free. If you're denied, you can reapply later if your finances change.

Local help in Taunton

Taunton is in Bristol County, where residents have access to a range of Medicare Part D and Medicare Advantage plans that include drug coverage. Choosing among them can feel overwhelming, especially if you're trying to figure out how Extra Help changes what you'd pay.

Massachusetts has a free counseling program called SHINE (Serving the Health Insurance Needs of Everyone), which is the state's version of the federal SHIP program. SHINE counselors are trained volunteers who can walk you through Extra Help, Medicaid eligibility, and plan comparisons. Their help is confidential and doesn't cost anything.